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 OJPathology  Vol.3 No.3 , July 2013
Pleomorphic Adenoma with Exuberant Squamous Metaplasia and Keratin Cysts Mimicking Squamous Cell Carcinoma in Minor Salivary Gland
Abstract: Salivary gland tumors, the second most common neoplasm of the mouth after squamous cell carcinoma, account for a significant proportion of tumors of the oral and perioral regions. An unusual case of adenoma presented as a solitary intraoral palatine mass in a 32-year-old woman is reported here. The tumor was interpreted as an unusual pleomorphic adenoma because of the presence of exuberant squamous metaplasia, clinically mimicking squamous cell carcinoma. Moreover, the presence of cystic structures filled with keratinized material was also salient feature. Pleomorphic adenomas may occasionally display focal squamous metaplastic changes; when extensive, it presents the potential for misinterpretation of the histology as indicative of well-differentiated squamous cell carcinoma.
Cite this paper: S. Lim, I. Cho, J. Park and S. Lim, "Pleomorphic Adenoma with Exuberant Squamous Metaplasia and Keratin Cysts Mimicking Squamous Cell Carcinoma in Minor Salivary Gland," Open Journal of Pathology, Vol. 3 No. 3, 2013, pp. 113-116. doi: 10.4236/ojpathology.2013.33020.
References

[1]   C. Margaritescu, M. Raica, M. Florescu, C. Simionescu, M. Surpateanu, F. Jaubert and F. Bogdan, “The Ultrastructural Aspects of Neoplastic Myoepithelial Cell in Pleomorphic Adenomas of Salivary Glands,” Journal of Cellular and Molecular Medicine, Vol. 8, No. 3, 2004, pp. 369-381. doi:10.1111/j.1582-4934.2004.tb00326.x

[2]   M. Batrani, M. Kaushal, A. K. Sen, R. Yadav and N. K. Chaturvedi, “Pleomorphic Adenoma with Squamous and Appendageal Metaplasia Mimicking Mucoepidermoid Carcinoma on Cytology,” CytoJournal, Vol. 6, 2008, p. 5. doi:10.4103/1742-6413.45496

[3]   V. C. Araujo, S. O. M. Souza, Y. R. Carvalho and N. S. Araujo, “Application of Immunohistochemistry to the Diagnosis of Salivary Gland Tumors,” Applied Immunohistochemistry and Molecular Morphology, Vol. 8, No. 3, 2000, pp. 195-202. doi:10.1097/00022744-200009000-00005

[4]   S. M. Standish and W. G. Shafer, “Serial Histologic Effects of Rat Submaxillary and Sublingual Salivary Gland Duct and Blood Vessel Ligation,” Journal of Dental Research, Vol. 36, No. 6, 1957, pp. 866-879. doi:10.1177/00220345570360060801

[5]   A. Englander and E. Cataldo, “Experimental Carcinogenesis in Duct-Artery Ligated Rat Submandibular Gland,” Journal of Dental Research, Vol. 55, No. 2, 1976, pp. 229-234. doi:10.1177/00220345760550021101

[6]   M. Friedman and J. W. Hall, “Radiation-Induced Squamous-Cell Metaplasia and Hyperplasia of the Normal Mucous Glands of the Oral Cavity,” Radiology, Vol. 55, No. 6, 1950, pp. 848-851.

[7]   S. M. Standish, “Early Histologic Changes in Induced Tumors of the Submaxillary Salivary Glands of the Rat,” American Journal of Pathology, Vol. 33, No. 4, 1957, pp. 671-689.

[8]   G. Seifert, K. Donath and G. Jautzke, “Unusual Choristoma of the Parotid Gland in a Girl. A Possible Trichodenoma,” Virchows Archives, Vol. 434, No. 4, 1999, pp. 355-359. doi:10.1007/s004280050352

[9]   E. F. Brachtel, B. Z. Pilch, U. Khettry, A. Zembowicz and W. C. Faquin, “Fine-Needle Aspiration Biopsy of a Cystic Pleomorphic Adenoma with Extensive Adnexa-Like Differentiation: Differential Diagnostic Pitfall with Mucoepidermoid Carcinoma,” Diagnostic Cytopathology, Vol. 28, No. 2, 2003, pp. 100-103. doi:10.1002/dc.10240

[10]   N. Siddaraju, P. Murugan, D. Basu and S. K. Verma, “Preoperative Cytodiagnosis of Cystic Pleomorphic Adenoma with Squamous Metaplasia and Cholesterol Crystals: A Case Report,” Acta Cytologica, Vol. 53, No. 1, 2009, pp. 101-104. doi:10.1159/000325093

[11]   J. L. Jensen, F. V. Howell, G. M. Rick and R. W. Correll, “Minor Salivary Gland Calculi. A Clinicopathologic Study of Forty-Seven New Cases,” Oral Surgery, Oral Medicine, and Oral Pathology, Vol. 47, No. 1, 1979, pp. 44-50. doi:10.1016/0030-4220(79)90100-2

[12]   A. M. Abrams, R. J. Melrose and F. V. Howell, “Necrotizing Sialometaplasia: A Disease Simulating Malignancy,” Cancer, Vol. 32, No. 1, 1973, pp. 130-135. doi:10.1002/1097-0142(197307)32:1<130::AID-CNCR2820320118>3.0.CO;2-8

[13]   R. Kruger and H. G. Dietrich, “Salivary Gland Infarction (Necrotizing Sialometaplasia)-Differential Diagnosis and Pathogenesis,” Pathologe, Vol. 3, No. 6, 1982, pp. 342-347.

[14]   E. F. Brachtel, B. Z. Pilch, U. Khettry, A. Zembowicz and W. C. Faquin, “Fine-Needle Aspiration Biopsy of a Cystic Pleomorphic Adenoma with Extensive Adnexa-Like Differentiation: Differential Diagnostic Pitfall with Mucoepidermoid Carcinoma,” Diagnostic Cytopathology, Vol. 28, No. 2, 2003, pp. 100-103. doi:10.1002/dc.10240

[15]   I. Paker, D. Yilmazer, A. T. Arikok, G. Saylam and S. Hucumenoglu, “Basal Cell Adenoma with Extensive Squamous Metaplasia and Cellular Atypia: A Case Report with Cytohistopathological Correlation and Review of the Literature,” Diagnostic Cytopathology, Vol. 40, No. 1, 2012, pp. 48-55. doi:10.1002/dc.21584

[16]   I. Dardick, M. T. Jeans, N. M. Sinnott, J. F. Wittkuhn, H. J. Kahn and R. Baumal, “Salivary Gland Components Involved in the Formation of Squamous Metaplasia,” American Journal of Pathology, Vol. 119, No. 1, 1985, pp. 33-43.

[17]   N. Siddaraju, P. Murugan, D. Basu and S. K. Verma, “Preoperative Cytodiagnosis of Cystic Pleomorphic Adenoma with Squamous Metaplasia and Cholesterol Crystals: A Case Report,” Acta Cytologica, Vol. 53, No. 1, 2009, pp. 101-104. doi:10.1159/000325093

 
 
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